Bone Metastases

Single-fraction stereotactic body radiotherapy (SBRT); seems to an effective option for patients with painful non-spine bone metastases and achieved higher pain response rates than standard multifraction radiotherapy (MFRT) in a phase 2 noninferiority study. The researcher aim was to test the hypothesis of equipoise between delivering a higher single fraction regimen; with advanced technology, SBRT; compared to standard MFRT 30 Gy in 10 fractions,” he said by email.
“They demonstrate(d) more durable pain control with a higher SBRT; dose in addition to better local control compared to the widely accepted multifraction standard regimen.” This trial supports previous randomized trials recommending that single fraction should the standard radiotherapy regimen; for bone metastases. “It is practice-changing because it demonstrates that by delivering a higher single fraction dose, clinicians will able to deliver a safe yet more effective durable treatment regimen; achieving better local control for patients than lower dose 8 Gy single fraction.”

Sites of bony metastases

Therefore the treatment groups balanced in terms of sex, age, ethnicity, tumor histology, sites of bony metastases, baseline pain scores, number of sites irradiated; Karnofsky performance status scores. The primary endpoint was pain response, defined by international consensus criteria as a combination of pain score and analgesic use. Lack of response was defined as worsening pain score (two or more points on a 0-to-10 scale); an increase in the morphine-equivalent opioid dose of 50% or more; re-irradiation, or pathologic fracture.

Treatment-related toxic effects

Further analyses showed no differences between the groups in treatment-related toxic effects or quality-of-life scores; whereas local control rates at one and two years were higher in patients receiving single-fraction SBRT. The team will start a phase 3 randomized trial in the near future, Dr. Nguyen noted
The studies excluded patients with fractures of the bone at the site treated or who had a history of prior radiation; to the site. Few patients with metastases to the spine included as treatment; at this site requires a specialized approach given the proximity of the spinal cord.”